Robert T. Trousdale, MD

Results showed use of an all-polyethylene tibial component in total knee arthroplasty may significantly lower surgical and total hospital admission costs while maintaining equivalent 90-day outcomes compared with metal-backed components.

In most acetabular revisions, an uncemented hemispherical socket with screws can be used (Figures 1 and 2). At the Mayo Clinic in Rochester, Minn., we routinely use morselized allograft for small cavitary defects and we use screws in 100% of our revision cases. However, in the past 15 years, we have learned that not all ingrowth surfaces are equal. There are limitations to the use of uncemented hemispheres alone, such as cases that involve huge deficiencies in which an allograft bears most of the cup, pelvic discontinuity, and in pathologic bone.

Advocates of minimally invasive and two-incision hip replacements claim that they provide the advantages of less soft tissue trauma near the hip joint, a potentially quicker recovery, less pain and a better functional result.